Planned Parenthood Funding: What About the Fraud?

Several states have either passed or are near passing new laws that would effectively bar Planned Parenthood (sometimes by name) from receiving government money—including Medicaid reimbursements.

The Obama administration has come to Planned Parenthood’s rescue. In the first of these instances, Indiana, the administration has issued a letter that says it is basically illegal to cut off Planned Parenthood Medicaid funding.

The Health and Human Services Department’s Medicaid administrator, Donald M. Berwick, said Indiana’s plan will improperly bar beneficiaries from receiving services. Federal law requires Medicaid beneficiaries to be able to obtain services from any qualified provider. “Medicaid programs may not exclude qualified health care providers from providing services that are funded under the program because of a provider’s scope of practice,” Berwick wrote.

But while this struggle rages, there is that 600-pound gorilla in the room that nobody wants to talk about. The question nobody wants to ask: How can Planned Parenthood continue to get taxpayer money when it has been found repeatedly guilty of filing fraudulent claims for government reimbursement?

We are not talking a simple mistake by a rogue employee. We are talking about mounting evidence of the systematic overbilling of taxpayers in states all across the country. We will look at several specific instances of this overbilling.

California – A 2004 audit found that Planned Parenthood of San Diego and Riverside Counties overcharged the government $5,213,645.92 for oral contraceptives. The problem was that Planned Parenthood was supposed to charge the government the cost of the pills. Instead, it charged a much higher price.

New York – A 2008 federal audit of state family planning claims resulted in a finding that the state of New York had overbilled the federal government $17,151,156 by claiming procedures as “family planning” services when they were not. The federal audit report noted that, “Officials at Planned Parenthood providers stated that they believed that nearly all the services they provide are related to family planning. However, the medical review determined that the providers improperly claimed, for example, services to pregnant women, treatment for sexually transmitted diseases, and counseling visits unrelated to family planning services.”

New Jersey – In 2008, the federal government conducted an audit of New Jersey and published a report, Review of Outpatient Medicaid Claims Billed as Family Planning by New Jersey, which showed the state had overcharged the federal government $597,496.00. In a section entitled “Causes of Overpayment,” the report states: “During our visits to family planning clinics throughout the State, many providers (especially Planned Parenthood providers) stated that they billed all claims to Medicaid as “family planning.” Officials at these clinics stated that they believed that all of the services they provided were related to family planning. Therefore, officials at these clinics often populated the family planning indicator field on Medicaid claims even though the service provided did not meet the criteria for 90-percent Federal funding. By populating this field, the MMIS designated the claim as eligible for 90-percent Federal funding.”

Washington – A 2009 audit found Planned Parenthood of the Inland Northwest overcharged the government $629,142.88. The audit found Planned Parenthood was charging excessive amounts for contraceptives and distributed and charged for prescription medication without having a valid prescription.

New York City – A 2009 Medicaid audit determined that Planned Parenthood’s Margaret Sanger Center in New York City was found to have overcharged Medicaid $1,254,603.00 which included double billing—billing Medicaid for services provided to patients who were enrolled in the provider’s HMO network.

Millions of dollars in overbilling and the federal government wants to keep giving Planned Parenthood our money.

The states have to repay millions of dollars to the federal government because Planned Parenthood wrongly claims that nearly all its services are “family planning” when they are not, yet the federal government is threatening to punish the states for cutting off funds to Planned Parenthood.

Looking at this situation, one might think that Planned Parenthood has a stranglehold on the Obama administration and is using its political clout to increase its profits and to thwart efforts by citizens all across the country to hold Planned Parenthood accountable for its actions.

Well, wait a minute. Wasn’t it President Obama and Senator Harry Reid who, a couple of months ago, threatened to close down the federal government and stop paying our soldiers if one penny was taken away from Planned Parenthood in the 2011 federal budget?

Perhaps we should just change the country’s name to the United States of Planned Parenthood.

Jim Sedlak is vice president of American Life League and a recognized expert on Planned Parenthood. Jim is the author the book, Parent Power!! and appears on numerous local and national radio talk programs. In 1993, Jim was identified by Planned Parenthood Federation of America as one of the 15 “most active” fighters against PP sex education programs. Jim cofounded and was director of STOPP (Stop Planned Parenthood International) from 1986 to 1994. He founded and was president of STOPP International from 1994 to 1998, when it merged into American Life League.